Individual
MARCIE B KLOOSTERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
23375 AMBER VALLEY DR, SOUTH BEND, IN 46628-8139
(219) 688-2348
Mailing address
23375 AMBER VALLEY DR, SOUTH BEND, IN 46628-8139
(219) 688-2348
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004143A
IN
Other
Enumeration date
09/10/2010
Last updated
09/10/2010
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